Form990-PF

Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Nonexempt Charitable Trust
Treated as a Private Foundation
Note. The foundation may be able to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0052
2010
For calendar year 2010, or tax year beginning 01-01-2010 , and ending 12-31-2010
G
Check all that apply:
Name of foundation
THE VIRGINIA & TOM GOSSAGE FOUNDATION I
 

Number and street (or P.O. box number if mail is not delivered to street address)US TRUST 231 S LASALLE ST IL1-231-113Room/suite
City or town, state, and ZIP code
CHICAGO, IL60604
A Employer identification number

31-1501910
B Telephone number (see page 10 of the instructions)

(404) 607-6219
C bullet
D 1. bullet
H Check type of organization:
2. bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$1,845,797
J Accounting method:
 
(Part I, column (d) must be on cash basis.)
E bullet
F bullet
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see page 11 of the instructions).) (a) Revenue and
expenses per
books
(b) Net investment
income
(c) Adjusted net
income
(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities...... 32,527 32,349  
5a Gross rents..............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 30,969
b Gross sales price for all assets on line 6a 554,600
7 Capital gain net income (from Part IV, line 2)... 30,969
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 63,496 63,318  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0   0
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... 2,960 0   2,960
c Other professional fees (attach schedule).... 6,675 6,675   0
17 Interest...............        
18 Taxes (attach schedule) (see page 14 of the instructions) 1,987 1,987   0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule).......        
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 11,622 8,662   2,960
25 Contributions, gifts, grants paid........ 118,700 118,700
26 Total expenses and disbursements. Add lines 24 and 25 130,322 8,662   121,660
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -66,826
b Net investment income (if negative, enter -0-) 54,656
c Adjusted net income (if negative, enter -0-)...  
For Privacy Act and Paperwork Reduction Act Notice, see page 30 of the instructions.
Cat. No. 11289X Form 990-PF (2010)
Form 990-PF (2010)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............... 1,781 1,781 1,781
2 Savings and temporary cash investments.......... 128,421 64,237 64,237
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see page 15 of the
instructions)....................      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use...............      
9 Prepaid expenses and deferred charges...........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)........ 1,385,795 Click to see attachment1,344,727 1,663,885
c Investments—corporate bonds (attach schedule)........ 0 Click to see attachment4,960 6,168
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans..............      
13 Investments—other (attach schedule)........... 63,095 Click to see attachment96,187 109,726
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 1,579,092 1,511,892 1,845,797
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable...................    
19 Deferred revenue..................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).......... 0 0
Net Assets or Fund Balances bullet
and complete lines 24 through 26 and lines 30 and 31.
24 Unrestricted....................    
25 Temporarily restricted................    
26 Permanently restricted................    
bullet
and complete lines 27 through 31.
27 Capital stock, trust principal, or current funds......... 1,577,311 1,510,111
28 Paid-in or capital surplus, or land, bldg., and equipment fund 0 0
29 Retained earnings, accumulated income, endowment, or other funds 1,781 1,781
30 Total net assets or fund balances (see page 17 of the
instructions).................... 1,579,092 1,511,892
31 Total liabilities and net assets/fund balances (see page 17 of
the instructions).................. 1,579,092 1,511,892
Part III Analysis of Changes in Net Assets or Fund Balances
1 Total net assets or fund balances at beginning of year—Part II, column (a), line 30 (must agree
with end-of-year figure reported on prior year’s return)............... 1 1,579,092
2 Enter amount from Part I, line 27a...................... 2 -66,826
3 Other increases not included in line 2 (itemize) bulletClick to see attachment 3 22
4 Add lines 1, 2, and 3.......................... 4 1,512,288
5 Decreases not included in line 2 (itemize) bulletClick to see attachment 5 396
6 Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 30.. 6 1,511,892
Form 990-PF (2010)
Form 990-PF (2010)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b) How acquired
P—Purchase
D—Donation
(c) Date acquired
(mo., day, yr.)
(d) Date sold
(mo., day, yr.)
1 a AMAZON COM INC P 2009-05-26 2010-01-05
b CHEVRONTEXACO CORP P 2009-11-17 2010-01-29
c CHEVRONTEXACO CORP P 2009-11-17 2010-01-29
d FPL GROUP INC P 2009-08-20 2010-01-29
e KIMBERLY CLARK CORP P 2009-11-17 2010-01-29
POLO RALPH LAUREN CORP CL A P 2009-08-20 2010-01-29
ADOBE SYSTEM INC P 2009-08-20 2010-01-29
COMCAST CORP NEW CL A P 2009-08-20 2010-01-29
EMC CORPORATION P 2009-08-20 2010-02-23
FPL GROUP INC P 2009-08-20 2010-02-23
PFIZER INC P 2009-08-20 2010-02-23
PEPSICO INC P 2009-10-01 2010-02-23
PEPSICO INC P 2009-10-06 2010-02-23
PEPSICO INC P 2009-10-21 2010-02-23
MONSANTO CO NEW P 2009-11-17 2010-03-04
STAPLES INC P 2009-09-25 2010-03-04
STAPLES INC P 2010-01-29 2010-03-04
PFIZER INC P 2009-08-20 2010-03-04
MONSANTO CO NEW P 2009-04-14 2010-03-04
DEAN FOODS CO NEW P 2009-08-20 2010-03-11
MOLSON COORS BREWING CO CL B P 2009-08-20 2010-03-18
MOLSON COORS BREWING CO CL B P 2009-09-04 2010-03-18
APOLLO GROUP INC CL A P 2009-08-20 2010-03-18
APOLLO GROUP INC CL A P 2009-09-25 2010-03-18
WILLIAMS COMPANIES P 2009-04-09 2010-03-26
PFIZER INC P 2009-08-20 2010-03-31
PFIZER INC P 2009-09-04 2010-03-31
F5 NETWORKS INC P 2009-10-15 2010-04-07
UNITED STS STL CORP P 2009-07-16 2010-04-08
ACTIVISION BLIZZARD INC P 2009-11-06 2010-04-16
SCHWAB CHARLES CORP NEW P 2009-05-26 2010-04-16
FREEPORT-MCMORAN COPPER & GOLD CL B P 2010-01-05 2010-04-20
FREEPORT-MCMORAN COPPER & GOLD CL B P 2010-02-05 2010-04-20
BP AMOCO P L C ADR P 2009-08-24 2010-04-29
PPL CORP P 2010-02-22 2010-04-29
PPL CORP P 2010-02-22 2010-04-29
PPL CORP P 2010-02-22 2010-04-29
CREE RESEARCH P 2009-12-22 2010-05-07
FREEPORT-MCMORAN COPPER & GOLD CL B P 2009-09-03 2010-05-07
FREEPORT-MCMORAN COPPER & GOLD CL B P 2010-02-05 2010-05-07
F5 NETWORKS INC P 2009-10-15 2010-05-07
ADOBE SYSTEM INC P 2009-08-20 2010-06-03
APOLLO GROUP INC CL A P 2009-08-20 2010-06-03
PEPSICO INC P 2009-10-06 2010-06-03
AXIS CAPITAL HOLDINGS LTD SHS P 2009-08-20 2010-06-03
PFIZER INC P 2009-09-04 2010-06-03
NOBLE CORPORATION P 2009-11-24 2010-06-03
PEPSICO INC P 2009-09-25 2010-06-03
NETFLIX COM INC P 2010-04-07 2010-06-15
ATHENAHEALTH INC P 2010-02-01 2010-07-02
AMPHENOL CORP NEW CL A P 2009-10-19 2010-08-05
EOG RES INC P 2009-08-20 2010-08-05
GILEAD SCIENCES INC P 2009-08-20 2010-08-05
GILEAD SCIENCES INC P 2009-08-20 2010-08-05
DIRECTV P 2009-12-18 2010-08-05
PRINCIPAL FINL GROUP INC P 2009-08-20 2010-08-05
PROCTER & GAMBLE CO P 2010-03-18 2010-08-05
AXIS CAPITAL HOLDINGS LTD SHS P 2009-08-20 2010-08-05
PROCTER & GAMBLE CO P 2010-01-29 2010-08-05
LOWES COMPANIES INC P 2010-01-05 2010-08-11
LOWES COMPANIES INC P 2009-09-03 2010-08-11
LOWES COMPANIES INC P 2009-11-11 2010-08-11
NETFLIX COM INC P 2010-07-29 2010-08-12
NABORS INDUSTRIES LTD SHS P 2009-08-20 2010-08-20
ARM HLDGS PLC SPONSORED ADR P 2010-01-28 2010-09-10
NETFLIX COM INC P 2010-04-07 2010-09-23
NETFLIX COM INC P 2010-07-29 2010-09-23
ARM HLDGS PLC SPONSORED ADR P 2010-01-28 2010-09-24
MICROSOFT CORP P 2010-01-19 2010-09-24
MICROSOFT CORP P 2009-11-05 2010-09-24
F5 NETWORKS INC P 2009-10-15 2010-10-08
ARM HLDGS PLC SPONSORED ADR P 2010-01-28 2010-10-08
DISCOVER FINL SVCS P 2009-12-18 2010-10-14
DISCOVER FINL SVCS P 2010-08-05 2010-10-14
GENERAL MILLS INC P 2010-06-03 2010-10-14
GENERAL MILLS INC P 2010-03-11 2010-10-14
GENERAL MILLS INC P 2010-03-18 2010-10-14
UNION PACIFIC CORP P 2010-09-13 2010-10-19
UNION PACIFIC CORP P 2010-05-24 2010-10-19
APPLE COMPUTER INC P 2009-11-17 2010-10-22
CHEVRONTEXACO CORP P 2009-11-17 2010-10-22
CHEVRONTEXACO CORP P 2009-11-24 2010-10-22
CLOROX CO P 2010-03-18 2010-10-22
DISCOVER FINL SVCS P 2009-12-18 2010-10-22
FIFTH THIRD BANCORP P 2010-06-03 2010-10-22
GANNETT INC P 2010-03-23 2010-10-22
INTERCONTINENTALEXCHANGE INC P 2010-10-14 2010-10-22
LOWES COMPANIES INC P 2010-01-29 2010-10-22
MCKESSON HBOC INC P 2009-11-17 2010-10-22
MEDCO HEALTH SOLUTIONS INC P 2010-06-03 2010-10-22
OCCIDENTAL PETROLEUM CORP P 2010-06-03 2010-10-22
PRICE T ROWE GROUP INC P 2010-08-05 2010-10-22
PROCTER & GAMBLE CO P 2010-10-14 2010-10-22
PRUDENTIAL FINL INC P 2009-12-18 2010-10-22
QEP RES INC P 2010-01-29 2010-10-22
QUESTAR CORP P 2010-10-14 2010-10-22
RIO TINTO PLC SPONSORED ADR P 2010-03-04 2010-10-22
SCHLUMBERGER LTD P 2010-08-20 2010-10-22
TJX COS INC NEW P 2010-03-18 2010-10-22
TARGET CORP P 2010-06-03 2010-10-22
AMERICAN TOWER SYS CORP CL A P 2010-03-04 2010-10-22
AMAZON COM INC P 2010-01-29 2010-10-22
ALPHA NAT RES INC P 2010-01-29 2010-10-22
ALLERGAN INC P 2010-03-31 2010-10-22
ALLERGAN INC P 2010-10-14 2010-10-22
AKAMAI TECHNOLOGIES INC P 2010-08-05 2010-10-22
TYCO INTL LTD P 2009-11-17 2010-10-22
TARGET CORP P 2010-08-05 2010-10-22
UNITED PARCEL SVC INC CL B P 2010-02-23 2010-10-22
WELLS FARGO & CO (NEW) P 2010-08-05 2010-10-22
UNITED PARCEL SVC INC CL B P 2010-02-23 2010-10-28
WELLS FARGO & CO (NEW) P 2010-08-05 2010-10-28
TYCO INTL LTD P 2009-11-17 2010-10-28
ABBOTT LABS P 2010-03-04 2010-10-28
AKAMAI TECHNOLOGIES INC P 2010-08-05 2010-10-28
ALLERGAN INC P 2010-03-31 2010-10-28
ALPHA NAT RES INC P 2010-01-29 2010-10-28
ALPHA NAT RES INC P 2010-08-20 2010-10-28
AMAZON COM INC P 2010-01-29 2010-10-28
AMERICAN TOWER SYS CORP CL A P 2010-03-04 2010-10-28
APPLE COMPUTER INC P 2009-11-17 2010-10-28
CLOROX CO P 2010-03-18 2010-10-28
CLOROX CO P 2010-02-23 2010-10-28
DISCOVER FINL SVCS P 2009-12-18 2010-10-28
DISCOVER FINL SVCS P 2010-01-29 2010-10-28
FIFTH THIRD BANCORP P 2010-05-26 2010-10-28
FIFTH THIRD BANCORP P 2010-06-03 2010-10-28
FIFTH THIRD BANCORP P 2010-06-03 2010-10-28
GANNETT INC P 2010-03-23 2010-10-28
GANNETT INC P 2010-06-03 2010-10-28
INTERCONTINENTALEXCHANGE INC P 2010-10-14 2010-10-28
MEDCO HEALTH SOLUTIONS INC P 2010-06-03 2010-10-28
PRICE T ROWE GROUP INC P 2010-08-05 2010-10-28
PROCTER & GAMBLE CO P 2010-01-29 2010-10-28
PRUDENTIAL FINL INC P 2009-12-18 2010-10-28
QEP RES INC P 2010-01-29 2010-10-28
QUESTAR CORP P 2010-10-14 2010-10-28
QUESTAR CORP P 2010-08-05 2010-10-28
RIO TINTO PLC SPONSORED ADR P 2010-03-04 2010-10-28
RIO TINTO PLC SPONSORED ADR P 2009-11-24 2010-10-28
SCHLUMBERGER LTD P 2010-08-20 2010-10-28
TJX COS INC NEW P 2010-03-18 2010-10-28
TJX COS INC NEW P 2010-03-04 2010-10-28
TARGET CORP P 2010-08-05 2010-10-28
ROCKWELL COLLINS INC P 2010-04-22 2010-11-18
ROCKWELL COLLINS INC P 2010-07-14 2010-11-19
ROCKWELL COLLINS INC P 2010-04-22 2010-11-19
NETFLIX COM INC P 2010-04-07 2010-11-30
GENERAL DYNAMICS CORP P 2010-04-28 2010-12-06
GENERAL DYNAMICS CORP P 2010-04-28 2010-12-06
GENERAL DYNAMICS CORP P 2010-05-27 2010-12-06
GENERAL DYNAMICS CORP P 2010-05-27 2010-12-06
GENERAL DYNAMICS CORP P 2010-05-17 2010-12-06
MARSH & MCLENNAN INC P 2008-10-10 2010-01-05
MARSH & MCLENNAN INC P 2008-07-09 2010-01-05
MARSH & MCLENNAN INC P 2008-10-10 2010-01-06
MARSH & MCLENNAN INC P 2008-10-10 2010-01-06
MARSH & MCLENNAN INC P 2008-12-02 2010-01-06
MARATHON OIL CORP P 2008-06-16 2010-01-11
FPL GROUP INC P 2008-06-16 2010-01-12
FPL GROUP INC P 2008-06-16 2010-01-12
FPL GROUP INC P 2008-06-16 2010-01-13
FPL GROUP INC P 2008-06-16 2010-01-13
FPL GROUP INC P 2008-06-16 2010-01-14
FPL GROUP INC P 2008-06-16 2010-01-14
QUALCOMM INC P 2008-06-16 2010-01-19
GILEAD SCIENCES INC P 2008-06-16 2010-01-26
COGNIZANT TECHNOLOGY SOLUTIONS P 2008-06-16 2010-01-26
YUM BRANDS INC P 2008-09-29 2010-01-29
KIMBERLY CLARK CORP P 2006-02-10 2010-01-29
CHEVRONTEXACO CORP P 2008-05-27 2010-01-29
CHEVRONTEXACO CORP P 2008-05-17 2010-01-29
CHEVRONTEXACO CORP P 2008-04-28 2010-01-29
AIR PRODUCTS & CHEMICALS INC P 2008-06-16 2010-02-09
AIR PRODUCTS & CHEMICALS INC P 2008-06-16 2010-02-10
AIR PRODUCTS & CHEMICALS INC P 2008-06-16 2010-02-11
VERIZON COMMUNICATIONS P 2008-02-08 2010-02-22
AT&T INC P 2006-02-10 2010-02-22
LOCKHEED MARTIN CORP P 2003-03-25 2010-02-23
TOTAL S A SPONSORED ADR P 2008-06-16 2010-02-23
TOTAL S A SPONSORED ADR P 2008-06-16 2010-02-23
TOTAL S A SPONSORED ADR P 2008-12-02 2010-02-23
AT&T INC P 2008-09-29 2010-03-04
MONSANTO CO NEW P 2008-09-29 2010-03-04
STAPLES INC P 2008-09-29 2010-03-04
COGNIZANT TECHNOLOGY SOLUTIONS P 2008-06-16 2010-03-09
DEAN FOODS CO NEW P 2008-09-29 2010-03-11
DEAN FOODS CO NEW P 2008-09-14 2010-03-11
DEAN FOODS CO NEW P 2008-10-26 2010-03-11
DISNEY WALT CO P 2006-10-02 2010-03-23
WILLIAMS COMPANIES P 2009-03-20 2010-03-26
WILLIAMS COMPANIES P 2009-03-20 2010-03-26
ACTIVISION BLIZZARD INC P 2008-07-14 2010-04-07
GILEAD SCIENCES INC P 2008-06-16 2010-04-07
JUNIPER NETWORKS INC P 2008-06-03 2010-04-07
AVON PRODUCTS INC P 2008-06-16 2010-04-08
FREEPORT-MCMORAN COPPER & GOLD CL B P 2009-03-05 2010-04-08
MONSANTO CO NEW P 2006-10-02 2010-04-13
MONSANTO CO NEW P 2008-09-21 2010-04-13
MONSANTO CO NEW P 2008-06-16 2010-04-13
SCHWAB CHARLES CORP NEW P 2008-12-17 2010-04-16
GOLDMAN SACHS GROUP INC P 2008-09-19 2010-04-16
ACTIVISION BLIZZARD INC P 2008-10-15 2010-04-16
ACTIVISION BLIZZARD INC P 2008-07-25 2010-04-16
ACTIVISION BLIZZARD INC P 2008-08-26 2010-04-16
ACTIVISION BLIZZARD INC P 2008-07-14 2010-04-16
MONSANTO CO NEW P 2008-10-10 2010-04-22
MONSANTO CO NEW P 2008-08-19 2010-04-22
MONSANTO CO NEW P 2008-10-10 2010-04-23
PHILIP MORRIS INTL INC P 2003-11-19 2010-04-27
AVON PRODUCTS INC P 2008-06-16 2010-04-27
FREEPORT-MCMORAN COPPER & GOLD CL B P 2009-03-05 2010-04-28
AVON PRODUCTS INC P 2008-06-16 2010-04-28
BP AMOCO P L C ADR P 2008-06-16 2010-04-29
BP AMOCO P L C ADR P 2008-06-16 2010-04-29
BP AMOCO P L C ADR P 2008-06-16 2010-04-29
NORDSTROM INC P 2009-04-29 2010-05-14
NORDSTROM INC P 2009-04-29 2010-05-14
NORDSTROM INC P 2009-04-17 2010-05-14
NORDSTROM INC P 2009-04-09 2010-05-17
PEABODY ENERGY CORP JR SUB DEB P 2008-06-17 2010-05-17
NORDSTROM INC P 2009-04-13 2010-05-17
NORDSTROM INC P 2009-04-29 2010-05-17
NORDSTROM INC P 2009-04-29 2010-05-17
NORDSTROM INC P 2009-04-29 2010-05-17
FREEPORT-MCMORAN COPPER & GOLD CL B P 2008-06-16 2010-05-21
AMERICAN EAGLE OUTFITTERS INC NEW P 2009-05-07 2010-05-27
MONSANTO CO NEW P 2008-10-10 2010-05-27
MONSANTO CO NEW P 2008-12-02 2010-05-27
MONSANTO CO NEW P 2008-12-02 2010-05-27
MONSANTO CO NEW P 2008-12-02 2010-05-27
MONSANTO CO NEW P 2008-10-10 2010-05-27
US BANCORP DEL NEW P 2008-09-29 2010-06-03
APOLLO GROUP INC CL A P 2008-11-25 2010-06-03
CELGENE CORP COM P 2008-06-16 2010-07-02
ATHENAHEALTH INC P 2009-02-24 2010-07-02
ATHENAHEALTH INC P 2009-02-24 2010-07-16
CHEVRONTEXACO CORP P 2008-04-29 2010-07-23
ATHENAHEALTH INC P 2009-03-09 2010-07-23
CHEVRONTEXACO CORP P 2008-06-16 2010-07-23
ATHENAHEALTH INC P 2009-02-24 2010-07-23
CHEVRONTEXACO CORP P 2008-04-10 2010-07-23
CHEVRONTEXACO CORP P 2008-05-09 2010-07-23
TEVA PHARMACEUTICAL INDS LTD P 2009-05-26 2010-07-28
TEVA PHARMACEUTICAL INDS LTD P 2009-06-17 2010-07-28
GILEAD SCIENCES INC P 2008-06-16 2010-07-28
TEVA PHARMACEUTICAL INDS LTD P 2008-10-21 2010-07-28
COLGATE PALMOLIVE P 2006-10-02 2010-07-29
GENERAL MILLS INC P 2008-06-16 2010-07-29
GENERAL MILLS INC P 2008-06-16 2010-07-30
GENERAL MILLS INC P 2008-06-16 2010-07-30
FRONTIER COMMUNICATIONS CORP P 2008-02-08 2010-08-04
OCCIDENTAL PETROLEUM CORP P 2008-06-16 2010-08-06
FRONTIER COMMUNICATIONS CORP P 2008-02-08 2010-08-06
FRONTIER COMMUNICATIONS CORP P 2008-02-08 2010-08-06
OCCIDENTAL PETROLEUM CORP P 2008-06-16 2010-08-06
WAL MART STORES INC P 2008-11-13 2010-08-06
WAL MART STORES INC P 2008-06-16 2010-08-06
OCCIDENTAL PETROLEUM CORP P 2008-06-16 2010-08-06
LOWES COMPANIES INC P 2009-05-14 2010-08-11
LOWES COMPANIES INC P 2009-04-28 2010-08-11
MASTERCARD INC CL A P 2008-06-16 2010-08-20
GOOGLE INC CL A P 2008-06-16 2010-08-20
SOUTHWESTERN ENERGY CO P 2008-02-08 2010-08-20
APPLE COMPUTER INC P 2008-06-16 2010-08-20
POTASH CORP SASK INC P 2009-04-28 2010-08-23
POTASH CORP SASK INC P 2009-05-26 2010-08-23
POTASH CORP SASK INC P 2009-04-28 2010-08-25
POTASH CORP SASK INC P 2008-12-11 2010-08-25
MCDONALDS CORP P 2008-10-20 2010-09-09
MCDONALDS CORP P 2008-10-20 2010-09-09
MCDONALDS CORP P 2008-10-20 2010-09-09
PG & E CORP P 2009-07-14 2010-09-10
PG & E CORP P 2009-07-14 2010-09-10
PG & E CORP P 2009-07-14 2010-09-13
PG & E CORP P 2009-07-13 2010-09-13
OCCIDENTAL PETROLEUM CORP P 2009-08-20 2010-10-22
NORDSTROM INC P 2009-08-20 2010-10-22
PACKAGING CORP AMER P 2009-09-25 2010-10-22
PACKAGING CORP AMER P 2009-08-20 2010-10-22
PARKER-HANNIFIN CP P 2009-09-25 2010-10-22
PARKER-HANNIFIN CP P 2009-08-20 2010-10-22
PEPSICO INC P 2009-09-25 2010-10-22
PHILIP MORRIS INTL INC P 2009-08-20 2010-10-22
SEMPRA ENERGY P 2009-08-20 2010-10-22
STAPLES INC P 2008-09-29 2010-10-22
TEXAS INSTRUMENTS INC P 2008-02-08 2010-10-22
THERMO ELECTRON CORP P 2009-08-20 2010-10-22
US BANCORP DEL NEW P 2008-09-29 2010-10-22
UNITED TECHNOLOGIES CORP P 2009-08-20 2010-10-22
UNITED TECHNOLOGIES CORP P 2002-06-28 2010-10-22
NABORS INDUSTRIES LTD SHS P 2009-08-20 2010-10-22
AT&T INC P 2008-09-29 2010-10-22
ABBOTT LABS P 2008-09-29 2010-10-22
AMGEN INC P 2009-08-20 2010-10-22
APACHE CORP P 2009-08-20 2010-10-22
AVON PRODUCTS INC P 2008-09-29 2010-10-22
CELANESE CORP DEL SER A P 2009-08-20 2010-10-22
CELANESE CORP DEL SER A P 2009-08-09 2010-10-22
CELANESE CORP DEL SER A P 2009-09-25 2010-10-22
CHEVRONTEXACO CORP P 2009-10-06 2010-10-22
CISCO SYSTEM INC P 2009-10-19 2010-10-22
CISCO SYSTEM INC P 2009-09-25 2010-10-22
COLUMBIA ACORN TR SELECT CL Z P 2006-10-02 2010-10-22
COLUMBIA FDS SER TR MID CAP VALUE P 2002-02-01 2010-10-22
DISNEY WALT CO P 2006-10-02 2010-10-22
DOVER CORP P 2009-10-21 2010-10-22
EMC CORPORATION P 2009-08-20 2010-10-22
EXELON CORP P 2005-05-23 2010-10-22
FLOWSERVE CORP P 2009-09-25 2010-10-22
GENERAL ELECTRIC CO P 1996-09-13 2010-10-22
GOLDMAN SACHS GROUP INC P 2008-09-29 2010-10-22
HEWLETT PACKARD CO P 2005-08-12 2010-10-22
INTERNATIONAL BUSINESS MACHINES P 2006-10-02 2010-10-22
JP MORGAN CHASE & CO P 2008-02-08 2010-10-22
LABORATORY CORP AMER HLDGS NEW P 2008-09-29 2010-10-22
LOWES COMPANIES INC P 2009-08-20 2010-10-22
MICROSOFT CORP P 1997-04-01 2010-10-22
MYLAN LABS INC P 2009-10-21 2010-10-22
MYLAN LABS INC P 2009-09-04 2010-10-22
NAVISTAR INTL CORP NEW P 2009-08-20 2010-10-22
NORDSTROM INC P 2009-09-25 2010-10-22
PNC BANK CORP P 2009-08-20 2010-10-22
OCCIDENTAL PETROLEUM CORP P 2009-08-20 2010-10-28
PNC BANK CORP P 2009-08-20 2010-10-28
PACKAGING CORP AMER P 2009-08-20 2010-10-28
PARKER-HANNIFIN CP P 2009-08-20 2010-10-28
PEPSICO INC P 2009-09-25 2010-10-28
PHILIP MORRIS INTL INC P 2009-08-20 2010-10-28
PHILIP MORRIS INTL INC P 2003-11-19 2010-10-28
SEMPRA ENERGY P 2009-08-20 2010-10-28
STAPLES INC P 2008-09-29 2010-10-28
TEXAS INSTRUMENTS INC P 2008-02-08 2010-10-28
THERMO ELECTRON CORP P 2009-08-20 2010-10-28
US BANCORP DEL NEW P 2008-09-29 2010-10-28
UNITED TECHNOLOGIES CORP P 2002-06-28 2010-10-28
WELLS FARGO & CO (NEW) P 2009-09-04 2010-10-28
WELLS FARGO & CO (NEW) P 2002-02-15 2010-10-28
NABORS INDUSTRIES LTD SHS P 2009-08-20 2010-10-28
NABORS INDUSTRIES LTD SHS P 2009-09-04 2010-10-28
TYCO INTL LTD P 2009-09-04 2010-10-28
TYCO INTL LTD P 2009-08-20 2010-10-28
AT&T INC P 2008-09-29 2010-10-28
AT&T INC P 2008-10-25 2010-10-28
AT&T INC P 2006-02-06 2010-10-28
AT&T INC P 2009-08-20 2010-10-28
ABBOTT LABS P 2008-09-29 2010-10-28
ABBOTT LABS P 2008-09-24 2010-10-28
AMGEN INC P 2009-08-20 2010-10-28
APACHE CORP P 2009-08-20 2010-10-28
APPLE COMPUTER INC P 2009-10-21 2010-10-28
AVON PRODUCTS INC P 2008-09-29 2010-10-28
CELANESE CORP DEL SER A P 2009-09-25 2010-10-28
CHEVRONTEXACO CORP P 2009-10-06 2010-10-28
CISCO SYSTEM INC P 2009-09-25 2010-10-28
DISNEY WALT CO P 2006-10-02 2010-10-28
DOVER CORP P 2009-10-21 2010-10-28
EMC CORPORATION P 2009-08-20 2010-10-28
EXELON CORP P 2005-05-23 2010-10-28
FLOWSERVE CORP P 2009-09-25 2010-10-28
FLOWSERVE CORP P 2009-08-20 2010-10-28
GENERAL ELECTRIC CO P 1996-09-13 2010-10-28
GOLDMAN SACHS GROUP INC P 2008-09-29 2010-10-28
HEWLETT PACKARD CO P 2005-08-12 2010-10-28
INTERNATIONAL BUSINESS MACHINES P 2006-10-02 2010-10-28
JP MORGAN CHASE & CO P 2008-02-08 2010-10-28
LABORATORY CORP AMER HLDGS NEW P 2008-09-29 2010-10-28
LOWES COMPANIES INC P 2009-08-20 2010-10-28
MCKESSON HBOC INC P 2009-09-04 2010-10-28
MCKESSON HBOC INC P 2009-08-20 2010-10-28
MEDCO HEALTH SOLUTIONS INC P 2009-10-21 2010-10-28
MICROSOFT CORP P 1997-04-01 2010-10-28
MYLAN LABS INC P 2009-09-04 2010-10-28
NAVISTAR INTL CORP NEW P 2009-08-20 2010-10-28
NORDSTROM INC P 2009-08-20 2010-10-28
LOWES COMPANIES INC P 2009-09-03 2010-11-15
LOWES COMPANIES INC P 2009-04-02 2010-11-15
PLUM CREEK TIMBER CO INC P 2008-06-16 2010-11-23
PLUM CREEK TIMBER CO INC P 2008-06-16 2010-11-23
PLUM CREEK TIMBER CO INC P 2008-06-16 2010-12-01
COLGATE PALMOLIVE P 2006-10-02 2010-12-06
GOODRICH (B F) CO P 2008-06-16 2010-12-06
GOODRICH (B F) CO P 2008-06-16 2010-12-06
FOOT LOCKER INC P 2009-10-08 2010-12-06
FOOT LOCKER INC P 2009-10-08 2010-12-06
FOOT LOCKER INC P 2009-10-08 2010-12-06
FOOT LOCKER INC P 2009-10-08 2010-12-06
PLUM CREEK TIMBER CO INC P 2008-06-16 2010-12-06
AVON PRODUCTS INC P 2008-06-16 2010-12-06
AVON PRODUCTS INC P 2008-06-16 2010-12-07
AVON PRODUCTS INC P 2008-12-02 2010-12-07
FOOT LOCKER INC P 2009-10-08 2010-12-07
FOOT LOCKER INC P 2009-08-12 2010-12-07
FOOT LOCKER INC P 2009-08-12 2010-12-07
GOODRICH (B F) CO P 2008-06-16 2010-12-07
F5 NETWORKS INC P 2009-10-15 2010-12-16
TEVA PHARMACEUTICAL INDS LTD P 2008-10-28 2010-12-16
TEVA PHARMACEUTICAL INDS LTD P 2008-10-21 2010-12-16
MICROSOFT CORP P 2009-11-05 2010-12-21
MICROSOFT CORP P 2009-11-05 2010-12-21
MICROSOFT CORP P 2009-07-14 2010-12-21
MICROSOFT CORP P 2009-07-23 2010-12-21
MASTERCARD INC CL A P 2008-09-19 2010-12-21
MASTERCARD INC CL A P 2008-06-16 2010-12-21
AOL TIME WARNER SECURITIES LITIGATION P 2002-11-22 2010-03-10
NORTEL NETWORKS CORP SECURITIES LITIGATION P 2001-02-15 2010-04-15
QWEST COMMUNICATIONS SERCURITIES LITIGATION P 2002-07-28 2010-05-06
NATIONS INTERNATIONAL EQUITY SECURITIES LITIGATION P 2003-06-20 2010-09-27
PRUDENTIAL SECURITIES SECURITIES LITIGATION P 2003-06-20 2010-09-30
CARDINAL HEALTH SECURTIES LITIGATION P 2004-07-26 2010-12-28
CAPITAL GAINS DIVIDENDS P    
(e) Gross sales price (f) Depreciation allowed
(or allowable)
(g) Cost or other basis
plus expense of sale
(h) Gain or (loss)
(e) plus (f) minus (g)
a 2,284   1,328 956
b 516   551 -35
c 1,032   1,032 0
d 2,446   2,852 -406
e 298   325 -27
2,069   1,662 407
1,486   1,446 40
2,448   2,264 184
1,545   1,363 182
1,639   1,996 -357
1,591   1,464 127
928   927 1
1,237   1,218 19
1,237   1,244 -7
890   924 -34
344   342 2
916   960 -44
1,638   1,545 93
223   266 -43
1,704   1,958 -254
1,951   2,053 -102
2,385   2,642 -257
1,292   1,287 5
646   707 -61
227   128 99
1,459   1,383 76
3,004   2,825 179
257   174 83
2,166   1,335 831
385   374 11
2,208   2,028 180
815   834 -19
570   483 87
107   104 3
1,358   1,599 -241
528   622 -94
179   207 -28
1,465   1,196 269
5,189   4,945 244
1,213   1,241 -28
2,278   1,565 713
1,801   1,767 34
259   322 -63
948   913 35
1,221   1,155 66
3,352   3,552 -200
2,063   3,109 -1,046
632   589 43
866   571 295
888   1,544 -656
4,046   3,741 305
2,543   1,842 701
607   785 -178
1,000   1,293 -293
2,321   1,986 335
3,180   3,377 -197
1,798   1,915 -117
2,049   1,877 172
1,499   1,545 -46
1,464   1,692 -228
40   42 -2
791   851 -60
1,834   1,370 464
915   969 -54
1,285   644 641
1,951   979 972
975   587 388
1,191   552 639
1,507   1,900 -393
1,087   1,258 -171
3,589   1,696 1,893
1,975   994 981
2,111   1,775 336
1,144   1,000 144
1,857   1,874 -17
3,342   3,248 94
1,114   1,101 13
1,429   1,347 82
673   561 112
3,076   2,062 1,014
759   709 50
506   472 34
682   646 36
1,040   888 152
1,091   1,091 0
1,034   1,417 -383
1,169   1,128 41
988   988 0
915   959 -44
1,025   1,171 -146
1,190   1,190 0
1,097   1,002 95
1,898   1,880 18
1,056   990 66
634   568 66
765   781 -16
1,607   1,361 246
1,017   852 165
1,119   1,076 43
1,074   1,087 -13
753   644 109
1,686   1,298 388
889   853 36
358   328 30
1,792   1,716 76
713   576 137
1,156   1,108 48
269   264 5
1,397   1,160 237
2,081   2,212 -131
1,009   870 139
129   138 -9
573   554 19
258   271 -13
1,285   960 325
2,546   2,293 253
902   853 49
226   202 24
2,502   1,948 554
774   644 130
1,527   1,031 496
664   646 18
332   305 27
174   148 26
1,129   894 235
637   625 12
382   392 -10
382   382 0
891   1,250 -359
475   598 -123
1,147   1,128 19
262   293 -31
1,367   1,253 114
2,209   2,164 45
1,591   1,485 106
972   852 120
675   695 -20
590   591 -1
982   817 165
1,309   1,055 254
1,042   852 190
691   646 45
922   818 104
1,570   1,585 -15
2,950   3,597 -647
2,228   2,243 -15
3,620   4,411 -791
3,282   1,305 1,977
335   384 -49
1,954   2,226 -272
67   68 -1
472   476 -4
674   711 -37
894   1,107 -213
255   352 -97
502   598 -96
437   527 -90
262   290 -28
3,452   5,477 -2,025
51   67 -16
205   267 -62
103   133 -30
510   667 -157
501   667 -166
750   1,001 -251
3,359   3,363 -4
3,961   4,757 -796
3,431   2,703 728
2,934   2,831 103
7,141   6,923 218
369   369 0
1,032   1,032 0
737   737 0
274   410 -136
68   102 -34
1,644   2,459 -815
1,071   1,325 -254
1,199   1,304 -105
3,480   2,073 1,407
511   733 -222
3,472   4,971 -1,499
1,252   1,091 161
2,612   3,119 -507
1,484   2,066 -582
1,489   1,478 11
4,704   3,343 1,361
1,084   1,646 -562
77   115 -38
77   104 -27
2,718   2,412 306
2,113   1,098 1,015
295   153 142
2,936   4,012 -1,076
1,543   1,838 -295
1,331   1,119 212
1,588   1,723 -135
940   411 529
2,704   1,874 830
68   106 -38
3,042   6,198 -3,156
476   419 57
9,736   7,762 1,974
2,682   2,881 -199
1,073   1,447 -374
2,589   3,598 -1,009
2,589   3,650 -1,061
196   242 -46
196   312 -116
196   242 -46
1,167   638 529
592   660 -68
2,296   1,120 1,176
585   660 -75
53   69 -16
1,382   1,799 -417
643   830 -187
40   22 18
396   220 176
713   397 316
39   21 18
2,961   4,628 -1,667
39   22 17
621   352 269
502   286 216
773   440 333
6   11 -5
470   515 -45
146   242 -96
394   582 -188
98   146 -48
49   73 -24
292   483 -191
2,699   4,108 -1,409
1,038   1,280 -242
3,998   4,866 -868
1,201   1,761 -560
1,352   2,077 -725
1,021   1,517 -496
1,623   1,634 -11
729   997 -268
319   423 -104
729   1,022 -293
365   504 -139
1,166   1,118 48
1,846   1,836 10
8,457   13,732 -5,275
2,866   2,473 393
3,583   2,867 716
2,670   2,388 282
720   643 77
309   276 33
1   1 0
227   270 -43
97   122 -25
203   254 -51
76   90 -14
514   530 -16
2,106   2,411 -305
1,985   2,342 -357
633   713 -80
791   854 -63
2,465   3,533 -1,068
1,846   2,300 -454
2,702   2,282 420
3,244   2,268 976
1,979   1,079 900
2,131   1,640 491
145   83 62
8,719   4,215 4,504
295   224 71
516   391 125
147   111 36
179   152 27
752   645 107
393   341 52
44   38 6
793   720 73
738   556 182
481   389 92
241   188 53
760   525 235
760   485 275
649   589 60
2,909   2,312 597
801   759 42
823   910 -87
1,717   1,773 -56
993   907 86
707   1,072 -365
2,245   1,706 539
748   340 408
386   352 34
1,831   1,931 -100
1,836   2,066 -230
862   905 -43
2,024   1,721 303
1,717   2,067 -350
168   131 37
168   129 39
504   365 139
844   700 144
1,055   1,093 -38
234   227 7
4,500   4,202 298
2,000   1,726 274
524   452 72
531   404 127
1,925   1,363 562
629   703 -74
571   496 75
561   514 47
1,576   1,344 232
1,713   955 758
2,093   1,230 863
2,065   2,398 -333
1,187   1,038 149
220   203 17
2,661   1,221 1,440
872   734 138
388   289 99
731   670 61
738   605 133
1,091   836 255
2,764   2,519 245
1,341   1,045 296
977   750 227
1,892   1,213 679
974   883 91
1,478   1,156 322
2,070   930 1,140
1,336   1,265 71
825   910 -85
2,194   2,216 -22
1,526   1,361 165
1,087   1,607 -520
3,726   1,702 2,024
2,193   2,281 -88
258   231 27
508   440 68
102   88 14
191   159 32
954   786 168
285   297 -12
542   509 33
29   27 2
1,427   1,279 148
1,807   2,066 -259
258   295 -37
861   905 -44
2,507   2,151 356
1,527   1,026 501
2,148   2,894 -746
1,421   974 447
2,963   2,451 512
1,625   1,590 35
727   603 124
794   607 187
2,516   1,817 699
614   703 -89
499   496 3
499   445 54
803   734 69
2,453   2,017 436
2,339   1,313 1,026
2,822   1,640 1,182
2,435   2,834 -399
1,204   1,038 166
1,496   1,422 74
325   278 47
975   829 146
787   855 -68
3,414   1,511 1,903
1,734   1,230 504
706   670 36
1,918   1,390 528
1,858   1,799 59
6,338   5,672 666
393   509 -116
894   1,158 -264
1,401   1,760 -359
1,868   1,496 372
344   215 129
429   269 160
39   24 15
58   36 22
771   484 287
96   60 36
781   973 -192
236   293 -57
205   257 -52
733   516 217
249   157 92
58   35 23
135   81 54
517   323 194
2,743   913 1,830
4,679   3,561 1,118
4,887   3,940 947
813   813 0
953   972 -19
673   555 118
2,186   1,981 205
8,385   8,729 -344
3,089   4,122 -1,033
98     98
26     26
242     242
72     72
63     63
364     364
3,921     3,921
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l) Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i) F.M.V. as of 12/31/69 (j) Adjusted basis
as of 12/31/69
(k) Excess of col. (i)
over col. (j), if any
a       956
b       -35
c       0
d       -406
e       -27
      407
      40
      184
      182
      -357
      127
      1
      19
      -7
      -34
      2
      -44
      93
      -43
      -254
      -102
      -257
      5
      -61
      99
      76
      179
      83
      831
      11
      180
      -19
      87
      3
      -241
      -94
      -28
      269
      244
      -28
      713
      34
      -63
      35
      66
      -200
      -1,046
      43
      295
      -656
      305
      701
      -178
      -293
      335
      -197
      -117
      172
      -46
      -228
      -2
      -60
      464
      -54
      641
      972
      388
      639
      -393
      -171
      1,893
      981
      336
      144
      -17
      94
      13
      82
      112
      1,014
      50
      34
      36
      152
      0
      -383
      41
      0
      -44
      -146
      0
      95
      18
      66
      66
      -16
      246
      165
      43
      -13
      109
      388
      36
      30
      76
      137
      48
      5
      237
      -131
      139
      -9
      19
      -13
      325
      253
      49
      24
      554
      130
      496
      18
      27
      26
      235
      12
      -10
      0
      -359
      -123
      19
      -31
      114
      45
      106
      120
      -20
      -1
      165
      254
      190
      45
      104
      -15
      -647
      -15
      -791
      1,977
      -49
      -272
      -1
      -4
      -37
      -213
      -97
      -96
      -90
      -28
      -2,025
      -16
      -62
      -30
      -157
      -166
      -251
      -4
      -796
      728
      103
      218
      0
      0
      0
      -136
      -34
      -815
      -254
      -105
      1,407
      -222
      -1,499
      161
      -507
      -582
      11
      1,361
      -562
      -38
      -27
      306
      1,015
      142
      -1,076
      -295
      212
      -135
      529
      830
      -38
      -3,156
      57
      1,974
      -199
      -374
      -1,009
      -1,061
      -46
      -116
      -46
      529
      -68
      1,176
      -75
      -16
      -417
      -187
      18
      176
      316
      18
      -1,667
      17
      269
      216
      333
      -5
      -45
      -96
      -188
      -48
      -24
      -191
      -1,409
      -242
      -868
      -560
      -725
      -496
      -11
      -268
      -104
      -293
      -139
      48
      10
      -5,275
      393
      716
      282
      77
      33
      0
      -43
      -25
      -51
      -14
      -16
      -305
      -357
      -80
      -63
      -1,068
      -454
      420
      976
      900
      491
      62
      4,504
      71
      125
      36
      27
      107
      52
      6
      73
      182
      92
      53
      235
      275
      60
      597
      42
      -87
      -56
      86
      -365
      539
      408
      34
      -100
      -230
      -43
      303
      -350
      37
      39
      139
      144
      -38
      7
      298
      274
      72
      127
      562
      -74
      75
      47
      232
      758
      863
      -333
      149
      17
      1,440
      138
      99
      61
      133
      255
      245
      296
      227
      679
      91
      322
      1,140
      71
      -85
      -22
      165
      -520
      2,024
      -88
      27
      68
      14
      32
      168
      -12
      33
      2
      148
      -259
      -37
      -44
      356
      501
      -746
      447
      512
      35
      124
      187
      699
      -89
      3
      54
      69
      436
      1,026
      1,182
      -399
      166
      74
      47
      146
      -68
      1,903
      504
      36
      528
      59
      666
      -116
      -264
      -359
      372
      129
      160
      15
      22
      287
      36
      -192
      -57
      -52
      217
      92
      23
      54
      194
      1,830
      1,118
      947
      0
      -19
      118
      205
      -344
      -1,033
      98
      26
      242
      72
      63
      364
      3,921
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
Bracket 2 30,969
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see pages 13 and 17 of the instructions).
If (loss), enter -0- in Part I, line 8 . . . . . . . . . . . . .
Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If “Yes,” the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see page 18 of the instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in)
(b)
Adjusted qualifying distributions
(c)
Net value of noncharitable-use assets
(d)
Distribution ratio
(col. (b) divided by col. (c))
2009      
2008      
2007      
2006      
2005      
2 Total of line 1, column (d) ...................... 2  
3 Average distribution ratio for the 5-year base period—divide the total on line 2 by 5, or by
the number of years the foundation has been in existence if less than 5 years
. . .
3  
4 Enter the net value of noncharitable-use assets for 2010 from Part X, line 5..... 4  
5 Multiply line 4 by line 3....................... 5  
6 Enter 1% of net investment income (1% of Part I, line 27b)........... 6  
7 Add lines 5 and 6......................... 7  
8 Enter qualifying distributions from Part XII, line 4.............. 8  
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See
the Part VI instructions on page 18.
Form 990-PF (2010)
Form 990-PF (2010)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see page 18 of the instructions)
1a Bulletand enter “N/A” on line 1. Bracket
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b 1 1,093
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2............................ 3 1,093
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-). 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 1,093
6 Credits/Payments:
a 2010 estimated tax payments and 2009 overpayment credited to 2010 6a 520
b Exempt foreign organizations—tax withheld at source....... 6b
c Tax paid with application for extension of time to file (Form 8868) 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 520
8 Enter any penalty for underpayment of estimated tax. if Form 2220 is attached. 8 1
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 574
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2011 estimated taxBullet   Refunded Bullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see page 19 of
the instructions for definition)?.............................
1b
 
No
If the answer is “Yes” to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If “Yes,” attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If “Yes,” attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If “Yes,” has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If “Yes,” attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
  • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If “Yes,” complete Part II, col. (c), and Part XV.
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see page 19 of the
    instructions)bulletGA
    b
    If the answer is “Yes” to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If “No,” attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2010 or the taxable year beginning in 2010 (see instructions for Part XIV on
    page 27)? If “Yes,” complete Part XIV...........................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If “Yes,” attach a schedule listing their names and addresses.
    10
     
    No
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. (see page 20 of the instructions) .......
    11
     
    No
    12
    Did the foundation acquire a direct or indirect interest in any applicable insurance contract before August 17, 2008?
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletTOM GOSSAGE Telephone no.bullet (404) 607-6209
    Located atbullet212 15TH ST NEATLANTAGA ZIP+4bullet303093507
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041.........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ......bullet
    15  
    16
    At any time during calendar year 2010, did the foundation have an interest in or a signature or other authority over
    a bank, securities, or other financial account in a foreign country? .................
    16
     
    No
    See page 20 of the instructions for exceptions and filing requirements for Form TD F 90-22.1. If "Yes", enter the name of the foreign country bullet  
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 5
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the “Yes” column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?.........................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?.................
    (6) Agree to pay money or property to a government official? (Exception. Check “No”
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).........
    b
    If any answer is “Yes” to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance (see page 20 of the instructions)?...
    1b
     
     
    .........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2010?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2010, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2010?...............
    If “Yes,” list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer “No” and attach statement—see page 20 of the instructions.) .........
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business
    enterprise at any time during the year?.....................
    b
    If “Yes,” did it have excess business holdings in 2010 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2010.)....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2010?
    4b
     
    No
    5a
    During the year did the foundation pay or incur any amount to:
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?...............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 509(a)(1), (2), or (3), or section 4940(d)(2)? (see page 22 of the instructions)...
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?........
    b
    If any answer is “Yes” to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance (see page 22 of the instructions)?
    5b
     
     
    .........bullet
    c
    If the answer is “Yes” to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?............
    If “Yes,” attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay
    premiums on a personal benefit contract?....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?....
    6b
     
    No
    If “Yes” to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If yes, did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 6
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation (see page 22 of the instructions).
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation
    (If not paid, enter
    -0-)
    (d) Contributions to
    employee benefit plans
    and deferred compensation
    (e) Expense account,
    other allowances
    MR TOM GOSSAGE PRESIDENT
    4.00
    0 0 0
    231 S LASALLE ST IL1-231-10-13
    CHICAGO,IL60604
    2 Compensation of five highest-paid employees (other than those included on line 1—see page 23 of the instructions).
    If none, enter “NONE.”
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position
    (c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation
    (e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    3 Five highest-paid independent contractors for professional services (see page 23 of the instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1
     
    2  
    3  
    4  
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 7
    Part IX-B
    Summary of Program-Related Investments (see page 23 of the instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See page 24 of the instructions.
    3  
    Total. Add lines 1 through 3...........................bullet0
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations,
    see page 24 of the instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    1,649,502
    b
    Average of monthly cash balances.......................
    1b
    49,209
    c
    Fair market value of all other assets (see page 24 of the instructions)............
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    1,698,711
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) ..............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d..........................
    3
    1,698,711
    4
    Cash deemed held for charitable activities. Enter 1 1⁄2% of line 3 (for greater amount, see page 25
    of the instructions) ............................
    4
    25,481
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    1,673,230
    6
    Minimum investment return. Enter 5% of line 5...................
    6
    83,662
    Part XI
    Distributable Amount bullet and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    83,662
    2a
    Tax on investment income for 2010 from Part VI, line 5......
    2a
    1,093
    b
    Income tax for 2010. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    1,093
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    82,569
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4.............................
    5
    82,569
    6
    Deduction from distributable amount (see page 25 of the instructions)...........
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII,
    line 1.................................
    7
    82,569
    Part XII
    Qualifying Distributions (see page 25 of the instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    121,660
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes................................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    121,660
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b (see page 26 of the instructions)............
    5
    0
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4...............
    6
    121,660
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 8
    Part XIII
    Undistributed Income (see page 26 of the instructions)
    (a)
    Corpus
    (b)
    Years prior to 2009
    (c)
    2009
    (d)
    2010
    1 Distributable amount for 2010 from Part XI, line 7 82,569
    2 Undistributed income, if any, as of the end of 2010:
    a Enter amount for 2009 only....... 67,526
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2010:
    a From 2005.......  
    b From 2006.......  
    c From 2007.......  
    d From 2008.......  
    e From 2009.......  
    fTotal of lines 3a through e......... 0
    4Qualifying distributions for 2010 from Part
    XII, line 4: bullet$ 121,660
    a Applied to 2009, but not more than line 2a 67,526
    b Applied to undistributed income of prior years
    (Election required—see page 26 of the instructions)
    0
    c Treated as distributions out of corpus (Election
    required—see page 26 of the instructions)...
    0
    d Applied to 2010 distributable amount..... 54,134
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2010. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ...........
    0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......
    0
    d Subtract line 6c from line 6b. Taxable
    amount—see page 27 of the instructions ...
    0
    e Undistributed income for 2009. Subtract line
    4a from line 2a. Taxable amount—see page 27
    of the instructions ...........
    0
    f Undistributed income for 2010. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2011 ..........
    28,435
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (see page 27
    of the instructions) ...........
    0
    8Excess distributions carryover from 2005 not
    applied on line 5 or line 7 (see page 27 of the
    instructions) .............
    0
    9Excess distributions carryover to 2011.
    Subtract lines 7 and 8 from line 6a ......
    0
    10 Analysis of line 9:
    a Excess from 2006....  
    b Excess from 2007....  
    c Excess from 2008....  
    d Excess from 2009....  
    e Excess from 2010....  
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 9
    Part XIV
    Private Operating Foundations (see page 27 of the instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2010, enter the date of the ruling.......bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........
    Tax year Prior 3 years (e) Total
    (a) 2010 (b) 2009 (c) 2008 (d) 2007
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....
             
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ....
             
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....
             
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets” alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)
             
    b “Endowment” alternative test— enter 2⁄3
    of minimum investment return shown in
    Part X, line 6 for each year listed...
             
    c “Support” alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....
             
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....
             
    (3) Largest amount of support
    from an exempt organization
             
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the organization had $5,000 or more in
    assets at any time during the year—see page 27 of the instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    MR TOM GOSSAGE
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number of the person to whom applications should be addressed:
    TOM GOSSAGE
    212 15TH ST NE
    ATLANTA,GA30309
    (404) 607-6219
    bThe form in which applications should be submitted and information and materials they should include:
    N/A
    cAny submission deadlines:
    N/A
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    N/A
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 10
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    Foundation
    status of
    recipient
    Purpose of grant or
    contribution
    Amount
    Name and address (home or business)
    aPaid during the year
    GEORGIA TECH FOUNDATION INC
    760 SPRING STREET NW STE 400
    ATLANTA,GA30308
    NONE EXEMPT SCHOLARSHIPS 25,000
    GEORGIA TECH FOUNDATION INC
    760 SPRING STREET NW STE 400
    ATLANTA,GA30308
    NONE EXEMPT GENERAL 1,000
    HIGHLANDS CASHIERS HOSPITAL FOUNDATION
    190 HOSPITAL DRIVE
    HIGHLANDS,NC28741
    NONE EXEMPT GENERAL 5,000
    HISTORIC OAKLAND FOUNDATION
    248 OAKLAND AVENUE SE
    ATLANTA,GA30312
    NONE EXEMPT GENERAL 52,000
    UNITED WAY OF COASTAL GEORGIA INC
    PO BOX 877
    BRUNSWICK,GA31521
    NONE EXEMPT GENERAL 1,200
    ATLANTA BOTANICAL GARDEN
    1345 PIEDMONT AVENUE NE
    ATLANTA,GA30309
    NONE EXEMPT GENERAL 2,500
    EMORY UNIVERSITY
    201 DOWMAN DRIVE
    ATLANTA,GA30322
    NONE EXEMPT GENERAL 2,000
    COLLEGE OF COASTAL GEORGIA FOUNDATION
    3700 ALTAMA AVENUE
    BRUNSWICK,GA31520
    NONE EXEMPT GENERAL 30,000
    Total .................................bullet 3a 118,700
    bApproved for future payment
    Total ..................................bullet 3b 0
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 11
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See page 28 of
    the instructions.)
    1Program service revenue: (a)
    Business code
    (b)
    Amount
    (c)
    Exclusion code
    (d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3Interest on savings and temporary cash investments          
    4 Dividends and interest from securities....     14 32,527  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8Gain or (loss) from sales of assets other than inventory     18 30,969  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory..          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 63,496 0
    13Total. Add line 12, columns (b), (d), and (e)...................
    1363,496
    (See worksheet in line 13 instructions on page 28 to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow
    Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the organization’s exempt purposes (other than by providing funds for such purposes). (See
    page 28 of the instructions.)
    Form 990-PF (2010)
    Form 990-PF (2010)
    Page 12
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section
    Yes
    No
    501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash....................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements............................
    1b(4)
     
    No
    (5) Loans or loan guarantees..............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is “Yes,” complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?...........
    b
    If “Yes,” complete the following schedule.
    (a) Name of organization (b) Type of organization (c) Description of relationship
    SignHere
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer or fiduciary) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    Signature of officer or trustee Date Title
    PaidPreparersUseOnly Preparer's SignatureBullet Date PTIN
    Firm's namebullet



    Firm's addressbullet







    Firm's EINbullet
    Phone no.
    Form 990-PF (2010)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2010 AccountingFeesSchedule
    Name:
    THE VIRGINIA & TOM GOSSAGE FOUNDATION I
    EIN: 31-1501910
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    TAX PREPARATION FEE 2,960 0   2,960

    TY 2010 InvestmentsCorpBondsSchedule
    Name:
    THE VIRGINIA & TOM GOSSAGE FOUNDATION I
    EIN: 31-1501910
    Name of Bond End of Year Book Value End of Year Fair Market Value
    NAVISTAR INTL CONV SR SUB NT DUE 10/15/14 1,131 1,335
    UNITED STS STL CORP CONV SR UNSECD NT DUE 5/15/14 1,335 1,940
    EMC CORP CONV SR NT DUE 12/01/11 2,494 2,893

    TY 2010 InvestmentsCorpStockSchedule
    Name:
    THE VIRGINIA & TOM GOSSAGE FOUNDATION I
    EIN: 31-1501910
    Name of Stock End of Year Book Value End of Year Fair Market Value
    ABBOTT LABS 8,365 8,049
    AIR PRODUCTS 4,533 4,548
    AMERICAN EXPRESS 2,330 2,704
    AMGEN INC 1,810 1,647
    AVON PRODS INC 4,512 3,633
    CISCO SYS INC 2,780 2,529
    DISNEY WALT CO 1,055 1,313
    GENERAL ELEC CO 1,247 1,555
    GENERAL MLS INC 3,245 3,773
    GENERAL MOTORS PFD 3,980 4,221
    GOLDMAN SACHS GROUP INC 3,361 4,204
    HEINZ H J CO 2,513 2,918
    HOME DEPOT INC 3,396 5,855
    ILLINOIS TOOL WKS INC 6,242 6,782
    INTEL CORP 1,833 2,713
    INTERNATIONAL BUSINESS MACHS 7,671 13,355
    LOWES COS INC 2,641 3,260
    MCKESSON CORP 2,210 2,815
    MICROSOFT CORP 13,915 19,146
    PARKER HANNIFIN CORP 3,379 6,386
    PEPSICO INC 1,766 1,960
    PHILIP MORRIS INTL INC 5,526 12,174
    PPG INDS INC 1,715 2,438
    PROCTER & GAMBLE CO 4,327 4,503
    STAPLES INC 1,819 1,822
    TARGET CORP 18,854 25,976
    UNITED TECHNOLOGIES CORP 6,023 13,933
    US BANCORP DEL 9,974 9,305
    WELLS FARGO & CO 7,197 9,638
    WILLIAMS COS INC 1,956 4,104
    ALLERGAN INC 17,706 20,601
    AMAZON COM INC 9,690 21,420
    AMERICAN TOWER CORP 1,502 1,807
    ANALOG DEVICES 1,516 2,336
    APACHE CORP 3,799 5,365
    APACHE PFD 3,066 3,859
    APPLE INC 18,684 36,449
    AUTOMATIC DATA PROCESSING INC 4,584 5,322
    CAMERON INTL 9,890 11,617
    CELGENE CORP 14,439 14,134
    CITRIX SYS INC 12,322 15,734
    COGNIZANT TECHNOLOGY SOLUTIONS 10,484 21,767
    DOVER CORP 2,357 3,858
    EMC CORP 3,256 4,924
    EXPRESS SCRIPTS INC 12,732 15,134
    GOOGLE INC 12,736 14,849
    INTUITIVE SURGICAL INC 5,299 9,021
    JOHNSON CNTLS INC 8,830 8,671
    JUNIPER NETWORKS INC 10,561 16,023
    MCDONALDS CORP 2,180 3,070
    MEDCO HLTH SOLUTIONS INC 1,916 2,144
    NETFLIX.COM INC 4,812 10,366
    OCCIDENTAL PETE CORP DEL 21,404 26,585
    PRICE T ROWE GROUP INC 3,338 5,550
    PRICELINE.COM INC 9,155 13,984
    QUALCOMM INC 15,183 15,886
    SCHLUMBERGER LTD 10,763 16,867
    SCHWAB CHARLES CORP NEW 9,898 11,258
    STARWOOD HOTELS & RESORTS 11,260 13,676
    TEXAS INSTRS INC 3,352 4,388
    THERMO FISHER SCIENTIFIC CORP 2,465 3,045
    TJX COS INC NEW 2,454 2,663
    UNION PAC CORP 8,133 15,474
    UNITED PARCEL SVC INC 3,850 4,573
    3M CO 2,002 1,985
    ALTRIA GROUP INC 1,919 2,881
    AMERICAN ELEC OWR INC 4,718 5,433
    AT&T INC 10,744 11,928
    CHEVRON CORP 11,190 12,958
    CITIGROUP INC PFD 2,547 3,144
    DISCOVER FINL SVCS 1,892 2,594
    EXELON CORP 1,641 1,457
    EXXON MOBIL CORP 5,411 6,069
    FIFTH THIRD BANCORP 2,532 3,009
    FORD MTR CO CAP TR II PFD 2,441 2,700
    FREEPORT-MCMORAN COPPER & GOLD 1,876 1,801
    HEWLETT PACKARD CO 2,269 4,000
    J P MORGAN CHASE & CO 13,382 12,471
    JOHNSON & JOHNSON 8,080 7,608
    KRAFT FOODS INC 2,049 2,521
    MERCK & CO INC 3,348 3,352
    METLIFE INC 4,104 3,777
    MORGAN STANLEY 1,745 2,068
    NEXTERA ENERGY INC 2,432 2,392
    PFIZER INC 3,418 4,167
    PG & E CORP 3,066 3,875
    PNC FINL SVCS GROUP INC 5,116 6,072
    PRUDENTIAL FINL INC 2,381 2,936
    SEMPRA ENERGY 5,424 5,353
    VERIZON COMMUNICATIONS INC 5,601 5,975
    XCEL ENERGY INC 5,010 5,487
    ALPHA NAT RES INC 1,708 2,701
    CLOROX CO 1,830 1,898
    FLOWSERVE CORP 1,335 1,788
    GENUINE PARTS CO 2,960 4,775
    GOODRICH CORP 3,432 6,165
    MYLAN INC 2,244 3,275
    NORDSTROM INC 3,962 6,187
    PEOPLES UTD FINL INC 2,460 2,480
    QEP RES INC 1,404 1,816
    VF CORP 2,071 2,241
    AKAMAI TECHNOLOGIES INC 1,536 1,882
    ALEXIAN PHARMACEUTICALS INC 9,334 9,102
    COLUMBIA ACORN FUND 112,910 135,609
    COLUMBIA ACORN SELECT FUND 85,945 121,552
    CREE INC 10,577 12,717
    DOLLAR TREE INC 9,303 11,328
    EXPEDITORS INTL WASHINGTON INC 13,852 17,581
    FS NETWORKS INC 4,304 12,886
    INTERCONTINENTAL EXCHANGE INC 1,692 1,787
    LABORATORY CORP AMER HLDGS 2,422 3,077
    PERRIGO CO 10,198 11,273
    CELANESE CORP DEL 1,581 2,676
    COLUMBIA MID CAP VALUE FUND 63,032 80,039
    FOOT LOCKER INC 1,321 2,276
    GANNETT INC 2,773 3,093
    MOLSON COORS BREWING CO 3,348 3,413
    NABORS INDS INC 877 1,173
    NAVISTAR INTL CORP NEW 1,341 1,737
    PACKAGING CORP AMER 2,431 3,850
    QUESTAR CORP 1,787 2,176
    ISHARES S&P GLOBAL INDUSTRIALS 13,328 15,079
    ISHARES S&P GLOBAL ENERGY SECTOR INDEX 13,278 14,062
    TYCO ELECTRONICS LTD 2,598 2,867
    ARM HLDGS PLC 4,904 11,060
    COLUMBIA MARSICO INTERNATIONAL 135,971 148,532
    DIAGEO PLC 6,188 6,169
    ISHARES S&P GLOBAL MATERIALS 13,453 15,016
    ISHARES S&P GLOBAL INFO TECHNOLOGY 14,007 15,047
    POTASH CORP SASK INC 10,852 11,922
    RIO TINTO PLC 2,991 4,300
    COLUMBIA INTERNATIONAL VALUE 93,599 81,457
    GLAXOSMITHKLINE PLC 2,505 2,432
    TYCO INTL LTD 2,358 3,108
    ENSCO PLC 2,525 2,989
    XL GROUP PLC 2,004 2,858
    ISHARES MSCI EMERGING MKTS INDEX 130,067 156,742

    TY 2010 InvestmentsOtherSchedule2
    Name:
    THE VIRGINIA & TOM GOSSAGE FOUNDATION I
    EIN: 31-1501910
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    BOSTON PRPERTIES INC. AT COST 3,987 3,530
    PIMCO COMMODITY REAL RETURN AT COST 92,200 106,196

    TY 2010 OtherDecreasesSchedule
    Name:
    THE VIRGINIA & TOM GOSSAGE FOUNDATION I
    EIN: 31-1501910
    Description Amount
    INCOME RECEIVED IN 2011 TAXED IN 2010 396


    TY 2010 OtherIncreasesSchedule
    Name:
    THE VIRGINIA & TOM GOSSAGE FOUNDATION I
    EIN: 31-1501910
    Description Amount
    INCOME RECEIVED IN 2010 TAXED IN 2009 22


    TY 2010 OtherProfessionalFeesSchedule
    Name:
    THE VIRGINIA & TOM GOSSAGE FOUNDATION I
    EIN: 31-1501910
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT MANAGEMENT FEES 6,645 6,645   0
    ANNUAL FILING FEE 30 30   0


    TY 2010 TaxesSchedule
    Name:
    THE VIRGINIA & TOM GOSSAGE FOUNDATION I
    EIN: 31-1501910
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES PAID 1,150 1,150   0
    FEDERAL TAXES PAID 520 520   0
    FEDERAL TAXES PAID 317 317   0